Fewer than one in six patient complaints to the Midland Regional Hospital, Portlaoise, is dealt with in the target time of 30 days, according to an unpublished HSE report.
Concerns over the hospital’s inability to deal with complaints and requests for information were identified by the hospital manager on 16 separate occasions between 2011 and 2014, but there was little evidence of any “purposeful action”, it says.
The hospital's performance in dealing with complaints in a timely manner is described as unacceptable in the report by former HSE national director of acute hospitals Ian Carter.
Portlaoise has been at the centre of controversy since early last year when it emerged that five babies had died in similar circumstances after being delivered there.
A Department of Health report published in February 2014 found the families of the dead children were treated in a poor and, at times, appalling manner. Information that should have been given to the families was withheld for no justifiable reason, according to chief medical officer Dr Tony Holohan.
‘Excessively onerous’
Last week, it emerged the HSE threatened to block publication of a draft Health Information and Quality Authority report which is highly critical of organisational structures and resources at the hospital.
Mr Carter, who also recommended the emergency department at Portlaoise be downgraded, said there was an “excessively onerous” number of committees – eight – within the hospital focused on quality and patient safety. No one individual had responsibility for the area.
His review was completed a year ago but was never published. The department has said the future configuration of services at Portlaoise will be determined within the Dublin Midlands Hospital Group of which it is a member.
The report says at no stage has the hospital managed to work within its budget. In 2013, for example, the budget was almost €45 million but it spent €53 million.
Cost containment plans were not achievable, there was no evidence of any use of opportunities offered by the Haddington Road agreement and no sanction was applied for consistent overspending, according to the report.
Spending on nursing and medical agency staff jumped by over 70 per cent from 2011, when a recruitment moratorium was put in place. “The replacement of front-line nursing and paramedical staff with higher cost, temporary agency staff does not make either fiscal or quality of patient care sense.”
Absence of clarity
Some 37 per cent of registrars employed at the hospital are supplied on an agency basis.
The report is critical of “uncertain” reporting arrangements in the hospital. An absence of clarity about roles and responsibilities has produced ambiguity and does not enable effective corporate control and direction, it says.
Management organisation is a “legacy arrangement” from the previous Midland Health Board structure which grouped hospitals in Portlaoise, Mullingar and Tullamore. In Portlaoise, the director of nursing and the clinical director report not to the hospital manager but to an assistant national director of hospitals. No specific job description has been developed for this post.
The report found the hospital had no service plan or strategic plan and this made role confusion, inappropriate actions and a failure to achieve key targets more likely.
